I am looking for guidance for coding of routine care associated with a clinical trial. I know CMS has a guidance for government payers, but my question is more specifically to the commercial payers. Per the coding book, DX V70.7 is for the "examiniation of a participant in clinical trial". There is also guidance in the book that states, "The codes are not to be used if the examiniation is for diagnosis of a suspected condition or for treatment purposes...". As an example, an oncology patient comes in for a clinic visit and also for labs, xray, chemo treatment. Does the clinic visit get coded or because there was additional treatment that day does it not get coded? Should all activities be coded with V70.7 if they are required activities for the study (but billable to insurance)?
Is anyone familiar with this? Any help is GREATLY appreciated.
Is anyone familiar with this? Any help is GREATLY appreciated.